Finding Understudied Disorders Potentially Associated with Maternal Morbidity and Mortality

Objective Clinical research literature focuses primarily on the most common causes of maternal morbidity and mortality (MMM). We explore sections of the discharge summaries of pregnant or postpartum women admitted to an intensive care unit (ICU) to identify associated disorders and mine the literature to identify knowledge gaps in clinical research. Methods Data for the study were discharge summaries in the MIMIC (Medical Information Mart for Intensive Care) database. We extracted a control cohort to study if there is a difference in comorbidities between pregnant and not pregnant patients with similar reasons for admission. We identified comorbidities of the Unified Medical Language System (UMLS) semantic types disease or syndrome, Mental or behavioral dysfunction, and injury, or poisoning. We used Entrez programming utilities (E-utilities) to query PubMed®. Results We identified 246 pregnant and postpartum patients. A control group of 587 not pregnancy related admissions matched on age and admit diagnosis. We found overlap of 24.3% discharge diagnoses between the two groups, and 7.5% of the codes exclusively in the pregnancy group. We identified 33 disease mentions not included in the most common reported causes of MMM. Conclusion Our results demonstrate that clinical text provides additional comorbidities associated with maternal complications that need further clinical research.

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MATERNAL SEPSIS;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.05.3239 ◽

2019 ◽

Vol 26 (05) ◽

Author(s):

Fehmida Parveen Memon ◽

Majida Khan ◽

Samya Aijaz

Keyword(s):

Maternal Morbidity ◽

Tertiary Care ◽

Morbidity And Mortality ◽

University Hospital ◽

P Value ◽

Care Hospital ◽

Maternal Complications ◽

Cross Sectional ◽

Maternal Morbidity And Mortality ◽

Maternal Sepsis

Objectives: To determine the thrombocytopenia as marker of maternal sepsis and its related maternal morbidity and mortality at tertiary care Hospital. Study Design: Cross-sectional study. Setting: Gynaecological and Obstetrical department of Liaquat University Hospital, Hyderabad. Period: 6 months from March 2017 to August 2017. Material and Methods: All the pregnant females with diagnosis of sepsis were enrolled in the study. All the females with chronic hepatitis were excluded. After complete clinical examination every women underwent 5cc blood sample for complete blood picture. Thrombocytopenia was characterized as a platelet count below 150.000/mm3. Data regarding maternal mortality and maternal complications was filled in the proforma. Results: Total 120 septic mothers were included in the study, 70 patients had thrombocytopenia and 50 were with normal platelets. Most of the women 71.7% were with age groups of 20-30 years. Out of total women 65.0% were un-booked. According to the maternal morbidity, septic shock was most common 36.7%, multi-organ failure was in 08.3%, prolonged Hospital stay was in 16.7%, ICU admission occurred in 18.3% patients, while renal failure, respiratory failure, hepatic failure, coagulopathy and metabolic acidosis were found with percentage of 09.2%, 02.5%, 10.8%, 10.8% and 03.3% respectively. Mortality rate was found among 8.3% out of total cases. Almost all complications were higher among women with thrombocytopenia as compare to women with normal platelets level, while statistically p-value was quite insignificant. Mortality was significantly high among patients with thrombocytopenia p-value 0.032. Conclusion: It was concluded that thrombocytopenia is a good marker for adverse outcome among septic mothers. Maternal morbidity and mortality was higher among septic women with thrombocytopenia.

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Prospective evaluation of maternal morbidity and mortality in post-cesarean section patients admitted to postanesthesia intensive care unit

Journal of Anaesthesiology Clinical Pharmacology ◽

10.4103/0970-9185.142844 ◽

2014 ◽

Vol 30 (4) ◽

pp. 508 ◽

Cited By ~ 3

Author(s):

Minal Harde ◽

Sona Dave ◽

Sachin Wagh ◽

Pinakin Gujjar ◽

Rakesh Bhadade ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Cesarean Section ◽

Maternal Morbidity ◽

Morbidity And Mortality ◽

Prospective Evaluation ◽

Maternal Morbidity And Mortality

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An Audit of Obstetric Admissions to Intensive Care Unit in a Medical College Hospital of Central India: Lessons in Preventing Maternal Morbidity and Mortality

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.5455/2320-1770.ijrcog20150225 ◽

2015 ◽

pp. 1 ◽

Cited By ~ 1

Author(s):

manisha jain ◽

jyoti modi

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Maternal Morbidity ◽

Central India ◽

Medical College Hospital ◽

Morbidity And Mortality ◽

College Hospital ◽

Medical College ◽

Maternal Morbidity And Mortality

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FETOMATERNAL OUTCOME IN PREGNANCY WITH CARDIAC DISEASE

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i7.2007 ◽

2021 ◽

Vol 5 (7) ◽

Author(s):

Kalyani K Bafna ◽

Kanaklata Nakum ◽

Aditi Vithal

Keyword(s):

Heart Disease ◽

Pregnant Women ◽

Cardiac Disease ◽

Maternal Morbidity ◽

Nyha Class ◽

Mode Of Delivery ◽

Fetal Outcome ◽

Morbidity And Mortality ◽

Maternal Complications ◽

Maternal Morbidity And Mortality

Objective(S): Cardiac disease is an important cause of maternal morbidity and mortality in both antepartum as well as in postpartum period. Incidence of heart disease with pregnancy is <1%. Aim of this study is to determine maternal complications with heart disease, mode of delivery & fetal complications. Materials & Methodology: This is a retrospective study conducted at Gopinath Maternity Home, Sir-T Hospital, Bhavnagar. From May 2020- April 2021. All pregnant women with various cardiac disease (previously established or diagnosed during pregnancy) who came to labor room or OPD are included. Result: 30 pregnant women out of 2683 deliveries were identified with cardiac disease giving prevalence of 1.12% in this study. 15(50%) women belonging to NYHA class-1 & 8(26.6%) belonged to NYHA class 2. Class 3(3 patients =10%) & class 4(4patients= 13.3%) were admitted immediately. 18(60%) women were case of valvular heart disease, out of which 12(66.6%) cases were of RHD, 2(11.1%) were MS, 3(16.6%) AS, 1(5.5%) MR. 10(33.33%) cases were congenital heart disease. Maternal mortality were 4(13.33%). Out of 30 cases, 18(69.2%) women had LSCS, 6(23.07%) had vaginal delivery,2(7.7%) had vaccum & 3(10.3%) had abortion. Out of 26 deliveries 2(7.7%) were IUFD, 6(23.07%) Preterm, 7(26.9%) IUGR. Total there were 9(37.5%) NICU admissions. Conclusion: Prognosis of pregnancy with heart disease has improved but management of it is still a challenge for obstetricians. Pre-conceptional counseling plays an important role by benefiting women with severe heart disease and thus help in reducing maternal morbidity and mortality. Keywords: cardiac disease, maternal outcome, fetal outcome

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Radiological evaluation of placental invasion anomalies: single center data

Aegean Journal of Obstetrics and Gynecology ◽

10.46328/aejog.v1i1.7 ◽

2019 ◽

Vol 1 (1) ◽

pp. 13-16

Author(s):

Sadettin Oguzhan Tutar ◽

Mehmet Özeren

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Maternal Morbidity ◽

Placenta Previa ◽

Information Management System ◽

Morbidity And Mortality ◽

Cesarean Sections ◽

Vaginal Deliveries ◽

Maternal Morbidity And Mortality ◽

Placental Invasion

Placenta previa totalis refers to the placenta lying over the lower uterine segment and completely covering the internal cervical os. The aim of this study was to predict the complications that may develop in cases with placenta previa totalis and most importantly, to decrease maternal morbidity and mortality rates. A total of 185 patients, who were diagnosed with placenta previa totalis in our clinic between January 2011 and December 2015 and underwent cesarean section, were included in the present study. Patients with placenta previa partialis, placenta previa marginalis, lower placenta pre-diagnosis, and placenta previa less than 24 weeks of gestation were excluded. Demographic data, gynecological and obstetric histories, type of surgical incision, placental adhesion anomalies, laboratory parameters, and blood transfusions of the patients were examined. Patients' type of application to our clinic, gestational week, birth weight, sex of the newborn, Apgar score of the first and fifth minutes, additional surgical interventions and complications developed were evaluated. The data were obtained using PROBEL Hospital Information Management System, which is the hospital electronic archive database. It was observed that a total of 60039 babies were delivered (29894 vaginal deliveries, 30145 cesarean sections) in our hospital during the study period. The frequency of the five-year placental invasion anomaly was found to be six in 10000 births. There was a statistically significant increase in the number of previous cesarean sections and invasion formation (p<0.05). Early diagnosis and adequate preoperative preparation are of great importance particularly in cases with placenta previa totalis who are thought to have an invasion. Patients should be referred to tertiary centers with high-quality blood bank unit, adult intensive care unit and neonatal intensive care unit, where a multidisciplinary approach can be offered. We believe that the elective operation of the cases is an important factor in reducing or preventing maternal morbidity and mortality.

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